Counseling and guidance


Published on

Published in: Science, Health & Medicine
  • Be the first to comment

No Downloads
Total views
On SlideShare
From Embeds
Number of Embeds
Embeds 0
No embeds

No notes for slide

Counseling and guidance

  1. 1. COUNSELLING AND GUIDANCE ABINAYA.T., MSW Page 1 UNIT 1 Guidance & Counselling Defining Guidance and Counselling and the Difference between them. Guidance and Counselling is defined as a planned and organized work aimed at assisting the trainee to understand himself and his abilities and develop his potentialities in order to solve his problems and achieve psychological, social, educational and professional compatibility, and also to achieve his objectives within the framework of Islamic teachings. Guidance and Counselling complement each other though there are some differences. Guidance is a group of planned services that include Counselling, it provides the trainee with miscellaneous information to upgrade his feeling of responsibility, understand himself and know his abilities and provide guidance services to trainees. Counselling on the other hand is the procedural aspect of guidance; it is therefore the interaction that comes as a result of the vocational relationship between a specialized counsellor and his student where the counsellor assists the student to understand himself and his abilities and talents to achieve self and environmental compatibility in order to attain the appropriate degree of mental health in light of the techniques and specialized skills of the guidance process The Difference Between Guidance and Counselling: The concept of guidance and counselling reflect a common meaning that includes awareness, assistance and change of behaviour to the better, but still there is a difference between the two concepts:-
  2. 2. COUNSELLING AND GUIDANCE ABINAYA.T., MSW Page 2 1- Guidance is more general and comprehensive than Counselling, it therefore includes Counselling. 2- Guidance usually precedes Counselling and paves the way for it. Counselling follows guidance. 3- Guidance stresses the theoretical aspect while Counselling takes care of the practical aspect. 4- Counselling is usually the relationship between the teacher and the student who comes for assistance; therefore it is an individualistic relationship. Misconceptions about guidance and Counselling: 1. Some people believe that Counselling is a mere service provided by the training institution. 2. Others believe that guidance and Counselling are services provided to psychiatric persons only, though it is provided to normal persons. 3. Some also believe that Counselling provides ready made plans and solutions to anyone who seeks Counselling, but the truth is that Counselling assists individuals to understand themselves and achieve self-realization. Guidance and counselling service 1. Religious Counselling: The counsellor cooperates with the Institute in urging the trainee to attend congregational prayer and implant Islamic values and Islamic doctrine into them through religious contests, lectures and connect activities and curricular with these Islamic values.
  3. 3. COUNSELLING AND GUIDANCE ABINAYA.T., MSW Page 3 2. Preventive Counselling: The preventive Counselling tries to prevent the occurrence of problems regarding study and training and it also tries to prevent social, psychological and health problems through inculcating awareness programs. 3. Educational Counselling: The educational Counselling aims at assisting the trainee to proceed with his studies smoothly by receiving new trainees and selection of gifted trainees and trainees who stagger in their studies and set special programs that help develop their talents and capabilities. 4. Vocational and Educational Counselling: The Educational and Vocational Counselling aims at educating the trainees about the various types of vocational and university education and the types of jobs and conditions of admission and employment at institutes, centers, military vocational institutes and colleges in order to assist in connecting education with development plans. 5. Social and Ethical Counselling: Social and Ethical Counselling aims at finding the suitable environment which enables the trainee to acquire skills and expertise in order to interact with others in accordance with the Islamic teachings.
  4. 4. COUNSELLING AND GUIDANCE ABINAYA.T., MSW Page 4 Ethical principles of counselling and psychotherapy Principles direct attention to important ethical responsibilities. Each principle is described below and is followed by examples of good practice that have been developed in response to that principle. Ethical decisions that are strongly supported by one or more of these principles without any contradiction from others may be regarded as reasonably well founded. However, practitioners will encounter circumstances in which it is impossible to reconcile all the applicable principles and choosing between principles may be required. A decision or course of action does not necessarily become unethical merely because it is contentious or other practitioners would have reached different conclusions in similar circumstances. A practitioner’s obligation is to consider all the relevant circumstances with as much care as is reasonably possible and to be appropriately accountable for decisions made. Being trustworthy: honouring the trust placed in the practitioner Being trustworthy is regarded as fundamental to understanding and resolving ethical issues. Practitioners who adopt this principle: act in accordance with the trust placed in them; strive to ensure that clients’ expectations are ones that have reasonable prospects of being met; honour their agreements and promises; regard confidentiality as an obligation arising from the client’s trust; restrict any disclosure of confidential information about clients to furthering the purposes for which it was originally disclosed. Autonomy: respect for the client’s right to be self-governing This principle emphasises the importance of developing a client’s ability to be self-directing within therapy and all aspects of life. Practitioners who respect their clients’ autonomy: ensure accuracy in any advertising or information given
  5. 5. COUNSELLING AND GUIDANCE ABINAYA.T., MSW Page 5 in advance of services offered; seek freely given and adequately informed consent; emphasise the value of voluntary participation in the services being offered; engage in explicit contracting in advance of any commitment by the client; protect privacy; protect confidentiality; normally make any disclosures of confidential information conditional on the consent of the person concerned; and inform the client in advance of foreseeable conflicts of interest or as soon as possible after such conflicts become apparent. The principle of autonomy opposes the manipulation of clients against their will, even for beneficial social ends. Beneficence: a commitment to promoting the client’s well-being The principle of beneficence means acting in the best interests of the client based on professional assessment. It directs attention to working strictly within one’s limits of competence and providing services on the basis of adequate training or experience. Ensuring that the client’s best interests are achieved requires systematic monitoring of practice and outcomes by the best available means. It is considered important that research and systematic reflection inform practice. There is an obligation to use regular and on-going supervision to enhance the quality of the services provided and to commit to updating practice by continuing professional development. An obligation to act in the best interests of a client may become paramount when working with clients whose capacity for autonomy is diminished because of immaturity, lack of understanding, extreme distress, serious disturbance or other significant personal constraints. Non-malfeasance: a commitment to avoiding harm to the client. Non- malfeasance involves: avoiding sexual, financial, emotional or any other form of client exploitation; avoiding incompetence or malpractice; not providing services when unfit to do so due to illness, personal circumstances or intoxication. The practitioner has an ethical responsibility to strive to mitigate
  6. 6. COUNSELLING AND GUIDANCE ABINAYA.T., MSW Page 6 any harm caused to a client even when the harm is unavoidable or unintended. Holding appropriate insurance may assist in restitution. Practitioners have personal and professional responsibility to challenge, where appropriate, the incompetence or malpractice of others; and to contribute to any investigation and/or adjudication concerning professional practice which falls below that of a reasonably competent practitioner and/or risks bringing discredit upon the profession. Justice: the fair and impartial treatment of all clients and the provision of adequate services The principle of justice requires being just and fair to all clients and respecting their human rights and dignity. It directs attention to considering conscientiously any legal requirements and obligations, and remaining alert to potential conflicts between legal and ethical obligations. Justice in the distribution of services requires the ability to determine impartially the provision of services for clients and the allocation of services between clients. A commitment to fairness requires the ability to appreciate differences between people and to be committed to equality of opportunity, and avoiding discrimination against people or groups contrary to their legitimate personal or social characteristics. Practitioners have a duty to strive to ensure a fair provision of counselling and psychotherapy services, accessible and appropriate to the needs of potential clients. Self-respect: fostering the practitioner’s self-knowledge and care for self The principle of self-respect means that the practitioner appropriately applies all the above principles as entitlements for self. This includes seeking counselling or therapy and other opportunities for personal development as required. There is an ethical responsibility to use supervision for appropriate personal and professional support and development, and to seek training and other opportunities for continuing professional development. Guarding against financial liabilities arising from work undertaken usually requires obtaining
  7. 7. COUNSELLING AND GUIDANCE ABINAYA.T., MSW Page 7 appropriate insurance. The principle of self-respect encourages active engagement in life-enhancing activities and relationships that are independent of relationships in counselling or psychotherapy. Characteristics of counsellor The practitioner’s personal moral qualities are of the utmost importance to clients. Many of the personal qualities considered important in the provision of services have an ethical or moral component and are therefore considered as virtues or good personal qualities. It is inappropriate to prescribe that all practitioners possess these qualities, since it is fundamental that these personal qualities are deeply rooted in the person concerned and developed out of personal commitment rather than the requirement of an external authority. Personal qualities to which counsellors and psychotherapists are strongly encouraged to aspire include: Empathy: the ability to communicate understanding of another person’s experience from that person’s perspective. Sincerity: a personal commitment to consistency between what is professed and what is done. Integrity: commitment to being moral in dealings with others, personal straightforwardness, honesty and coherence. Resilience: the capacity to work with the client’s concerns without being personally diminished. Respect: showing appropriate esteem to others and their understanding of themselves. Humility: the ability to assess accurately and acknowledge one’s own strengths and weaknesses.
  8. 8. COUNSELLING AND GUIDANCE ABINAYA.T., MSW Page 8 Competence: the effective deployment of the skills and knowledge needed to do what is required. Fairness: the consistent application of appropriate criteria to inform decisions and actions. Wisdom: possession of sound judgement that informs practice. Courage: the capacity to act in spite of known fears, risks and uncertainty. A Brief History of Counselling and Therapy Counselling has not had a long history in its current form, yet it has happened for centuries and longer. Family and religion There has been a long need for Counselling in helping individuals with transitions and other difficulties in their lives. The long tradition of Counselling is first of family members helping with advice. Parents counsel their children. Grandparents and other family elders offer the wisdom of the years. In a close community, there may also be tribal elders or others with a concern for mental well-being. This role for many years was (and still is) taken on by the priest or religious person. For the individual, the priest offers confidentiality that enables discussion of family matters or things that are secret from the family. The priest meanwhile gets to steadily inculcate religious values, making it a valued relationship on both sides. The church tended to view mental illness as some form of possession and treatment, including exorcism, was of the soul rather than the body. Those with more incurable issues were generally tolerated. The village idiot was found a place in the fields and others were cared for or handled within the community.
  9. 9. COUNSELLING AND GUIDANCE ABINAYA.T., MSW Page 9 The industrial revolution With the age of the enlightenment and the rise of the industrial revolution through the eighteenth and nineteenth centuries, populations became mobile as they sought employment in towns and cities that were often far from their original homes. This separated them from their natural counselors, although the religious support was still available. Yet with the rise of science, the power of the church declined and it was not always able to give the help that was needed. Capitalism and science also had subtle effects on beliefs, values and general cognition. Everything had to be explained. The work ethic was dominant and hedonism was an option for only a few. Along with the concentration of towns and cities came the need to protect its citizens and civic organizations such as police forces were developed. In small communities the power of shame and the threat of banishment is enough to sustain social control. In town, anonymity is an option which brings its own problems. Particularly in America, social mobility was very much a norm. As much to protect the populace as the individual concerned, somewhere between the workhouse, hospital and prison sat the lunatic asylum. Here, the insane (as well as a few unhappy individuals who had embarrassed their families) were incarcerated with little treatment. Science scoffed at the notion of possession by demons but had little idea what to do beyond basic approaches such as drugging and leeching. In the cruel days of misfit sideshows, the asylum was just another place to go and laugh at those less fortunate. The rise of psychotherapy Hypnotism had been known about for some time (Mesmer lived around the turn of the eighteenth century), and was popular through the ninteenth century and was used as an informal therapeutic method. Nevertheless it perplexed scientists who were suspicious of its shamanistic roots.
  10. 10. COUNSELLING AND GUIDANCE ABINAYA.T., MSW Page 10 With the continued development and dominance of scientific medicine, establishment attention was eventually turned to matters of the mind (something that empiricists had largely ignored as impenetrable). Medical science took over as the caretakers of the mentally disturbed and a new age of and discipline of psychiatry arose towards the end of the nineteenth century. Sigmund Freud was perhaps the most significant pioneer in seeking to understand and treat mental problems, at least in those who lived in normal society but who suffered from emotional and behavioral difficulties. Rather than try to treat mental problems as a physical issue, he chose to listen to them and try to work out what was happening from what they said, and then apply treatment in the opposite direction, again through words. Despite massive leaps, Freud was still trapped by notions of his day, such as the assumption that mental problems had an emotional basis and the derivation of ideas such as libido came from nineteenth century biological theories. Psychoanalysis thus developed and was evolved by people such as Jaques Lacan and Melanie Klein into the approaches still used today. This was not without some internal division of opinion and Klein famously split with Sigmund Freud's daughter, the more traditionalist Anna. Behaviorism and humanism In the way that a thing creates its opposite, the assumptions of psychoanalysis were challenged in the scientific search for hard evidence, andbehaviorism and conditioning became popular for the focus on the external, measurable behavior. In the opposite direction, and particularly in the more liberal America, a different view arose amongst people such as Carl Rogers, Albert Ellis, Eric Berne and Abraham Maslow. These put the person and their experience at the middle of attention, as opposed to the more therapist and method focus of psychoanalysis. This may seem unfair but the humanist approach is just that -
  11. 11. COUNSELLING AND GUIDANCE ABINAYA.T., MSW Page 11 human. It sees the client as a collaborative partner, not as a patient to be treated by an expert. Humanism, even more than Behaviorism and quite unlike Psychoanalysis, has a focus on the present rather than the past. Humanism was largely a practitioner philosophy and was largely ignored by academe for a long time. Nevertheless its warm message resonated with both therapists and clients and it was widely used. Despite secular leanings, this approach was influenced by Protestant values such as free choice by the individual and the personal journey. Secular society With the decline of the church as a social institution that exists at the heart of the community and the lives of its people, there arose a vacuum of meaning and care. Without the comfort of promised salvation, many lost their sense of purpose in the meaningless daily drudge. And without the sage and certain advice of the priest, the neuroses of industrial living worsened. Cities can be lonely places. With family far away and fickle friends who enjoy the fun but step back when emotional support is needed, a person can be out and dancing yet feel terribly alone. In such an environment there is a vacuum, a pent-up need for help towards the making of meaning for individual lives. It was this need, this pull, that created the new disciplines of therapy and Counselling. It was the loss created by sundered societies that drove some to despair and other to consider what succor and treatment could be provided to create a more harmonious. Those who wanted just to do good and those who saw the social imperative worked to develop ways and means of putting people back together and back into society. In pursuit of happiness and the American Dream, self-development was a common focus. Even in the first world war, the US army employed psychologists and psychological testing was widespread.
  12. 12. COUNSELLING AND GUIDANCE ABINAYA.T., MSW Page 12 Twentieth century expansion Psychotherapy first caught on in a significant way in the USA, helped by a receptive culture and by European analysts who moved there away from fascist oppression. These ideas were then adopted into the American culture. Humanism in particular, as described above, was a particularly American approach. There is a notion of the 'empty self' and an American theme has been the search for meaning and the focus on the individual's story (the empty self is also a possible cause in the rise of consumerism and advertising). In the latter half of the twentieth century, Counselling developed significantly as a distinct profession, differing from therapy at least in the contexts of use and often in the types of issues faced. Counselling happens in the social community, in schools and colleges as well as homes. Counselling is often paid for by the community or is voluntarily offered (such as the Samaritans). Therapy is more likely to be a private practice. Therapy is largely found in the therapist's work room. Counselling addresses issues from small to large. Therapy tends to deal in the bigger issues. Counselling may be limited. Therapy can continue as long as the client is able to pay. As with other new domains, there has been division of viewpoint and evolution of schools of thought. There have been views of Counselling and therapy as a means to social change. The counselor-client relationship has been questioned. Even the dynamics resulting from the structure of expert-patient has been questioned. Throughout the development of Counselling and therapy, there has been an evolution of thought about the way people are perceived and hence treated. Freud viewed the person as conflicted and hidden. Behaviorists saw people as predictable machines. Humanists had a more botanical image, with ideas of feeding and growth. The perception of the client can significantly affect the counselor's view and hence how they interact with them.
  13. 13. COUNSELLING AND GUIDANCE ABINAYA.T., MSW Page 13 UNIT 2 Group counselling Group counselling is a form of therapy, which posits that people benefit from shared experiences. Usually, it's focused on a particular issue, like obsessive- compulsive disorder orangery. While a therapist usually manages the group, contributions from other members are considered valuable since all in the group share similar issues. One of the main principals behind group Counselling is the idea that dealing with specific issues may cause isolation, and a feeling that one is alone in facing his or her problems. This form of Counselling attempts to counteract isolation by assembling people with similar issues to enforce that difficulties are not singular to one person. Additionally, knowing other people with similar troubles can be comforting to individuals who may not have access in their own family and friends to people with the same problem. Group Counselling may be highly organized, with people doing specific activities together and then sharing the results. Alternately, it may be more freeform, where members share their current issues related to the group’s purpose. One person’s verbal contributions to a group might be discussed, validated, and provoke problem solving by other group members in a session. It might also be an entry into a discussion regarding a certain aspect of an illness or condition that is then primarily led by the therapist. Group Counselling Techniques Psychotherapy, on the other hand, is a distinct form of psychological Counselling. Sessions may occur in an individual setting or through groupCounselling, but are always administered by a person trained and
  14. 14. COUNSELLING AND GUIDANCE ABINAYA.T., MSW Page 14 licensed in psychology. While there are several support groups that exist to provide guidance and a mechanism for recovery to substance abusers, not all groups for substance abusers are necessarily group therapy or group Counselling. The distinction between substance abuse group therapy and supportgroups is that the first are led by mental health and substance abuse treatment professionals, while support groups are often peer-led and do not offer psychotherapy or Counselling within the context of the group's operations. Group Counselling Activities Additionally, knowing other people with similar troubles can be comforting to individuals who may not have access in their own family and friends to people with the same problem. Group Counselling may be highly organized, with people doing specific activities together and then sharing the results. The activities are conducted in a group setting to make it easier for participants to share intimate thoughts and recover from psychological problems, to foster a stronger bond within the group, and to carry out group Counselling. A trained facilitator typically presides over the activities and the group therapy. Career Counselling Career Counselling, career guidance and career coaching are similar in nature to other types of Counselling or coaching, e.g. marriage or psychological Counselling. What unites all types of professional Counselling is the role of practitioners, who combine giving advice on their topic of expertise with Counselling techniques that support clients in making complex decisions and facing difficult situations. The focus of career Counselling is generally on issues
  15. 15. COUNSELLING AND GUIDANCE ABINAYA.T., MSW Page 15 such as career exploration, career change, personal career development and other career related issues. Around the globe, countless definitions, concepts and terminology exist for career Counselling - particularly due to cultural and linguistic differences.[1] This even affects the most central term Counselling (or: counselling in British English) which is often substituted with the word guidance as in career guidance. For example, in the UK, career Counselling would usually be referred to as careers advice or guidance. Due to the widespread reference to both career guidance and career Counselling among policy-makers, academics and practitioners around the world, references to career guidance and counselling are becoming common.[2] Accordingly, this article emphasizes a broad understanding of career Counselling which involves a variety of professionals activities commonly associated with career Counselling, guidance, coaching, and advise. More specific roles and activities associated with career Counselling are explained below. Related professional activities Career Counselling or career guidance includes a wide variety of professional activities which focus on supporting people in dealing with career-related challenges - both preventively and in difficult situations (such as unemployment). Career counselors work with people from various walks of life, such as adolescents seeking to explore career options, experienced professionals contemplating a career change, parents who want to return to the world of work after taking time to raise their child, or people seeking employment. Career counselling is also offered in various settings, including in groups and individually, in person or by means of digital communication.
  16. 16. COUNSELLING AND GUIDANCE ABINAYA.T., MSW Page 16 Several approaches have been undertaken to systemize the variety of professional activities related to career guidance and Counselling. In the most recent attempt, the Network for Innovation in Career Guidance and Counselling in Europe (NICE) - a consortium of 45 European institutions of higher education in the field of career Counselling - has agreed on a system of professional roles for guidance counselors. Each of these five roles is seen as an important facet of the career guidance and counselling profession. Career counselors performing in any of these roles are expected to behave professionally, e.g. by following ethical standards in their practice. The NICE Professional Roles (NPR) are:[3] The Career Educator "supports people in developing their own career management competences" The Career Information & Assessment Expert "supports people in assessing their personal characteristics and needs, then connecting them with the labour market and education systems" The Career Counsellor "supports individuals in understanding their situations, so as to work through issues towards solutions" The Programme & Service Manager "ensures the quality and delivery of career guidance and counselling organisations' services" The Social Systems Intervener & Developer "supports clients (even) in crisis and works to change systems for the better" Benefits Professional career counselors can support people with career-related challenges in many ways (see above). Through their expertise in career development and labor markets, they can put a person's qualification, experience, strengths and weakness in a broad perspective taking into consideration their desired salary,
  17. 17. COUNSELLING AND GUIDANCE ABINAYA.T., MSW Page 17 personal hobbies and interests, location, job market and educational possibilities. Through their counselling and teaching abilities, career counselors can additionally support people in gaining a better understanding of what really matters for them personally, how they can plan their careers autonomously, or help them in making tough decisions and getting through times of crisis. Finally, career counselors are often capable of supporting their clients in finding suitable placements/ jobs, in working out conflicts with their employers, or finding the support of other helpful services. It is due to these various benefits of career Counselling that policy-makers in many countries of the world publicly fund guidance services. For example, the European Union understands career guidance and Counselling as an instrument to effectively combat social exclusion and increase citizens' employability.[8] History Frank Parson's Choosing a Vocation (1909) was perhaps the first major work which is concerned with careers guidance. While until the 1970s a strongly normative approach was characteristic for theories (e.g. of Donald E. Super's life-span approach) and practice of career Counselling (e.g. concept of matching), new models have their starting point in the individual needs and transferable skills of the clients while managing biographical breaks and discontinuities. Career development is no longer viewed as a linear process. More consideration is now placed on nonlinear, chance and unplanned influences. Training Up until now there is no standardized qualification path for professional career counselors, although various certificates are offered nationally and internationally (e.g. by professional associations), and the number of academic degree programs in career guidance and/or career Counselling is growing
  18. 18. COUNSELLING AND GUIDANCE ABINAYA.T., MSW Page 18 worldwide. Still, in most countries, basically anybody could call themselves a "career counselor" (unlike engineers or psychologists whose professions are protected legally). At the same time, policy makers agree that the competence of career counselors is one of the most important factors in ensuring that people receive high quality support in dealing with their career questions.[9] Depending on the country of their education, career counselors may have a variety of academic backgrounds: In Europe, for instance, degrees in (vocational/ industrial/ organization) psychology and educational sciences are among the most common, but backgrounds in sociology, public administration and other sciences are also frequent.[10] At the same time, many training programs for career counselors are becoming increasingly multidisciplinary. Professional career guidance centres There are many career guidance and Counselling centres all over the world. They give services of guidance and Counselling on higher studies, possibilities, chances and nature of courses and institutes. Also that these services are offered either fixing up a meeting with the Experts or having telephonic conversations with the guide or even the online guidance which is very common these days with the people getting services on click of their mouse. There are many such service providers all over the world providing online Counselling to people about their career or conducting a psychometric test to know the persons aptitude as well as interests. Career testing People who participate in career Counselling can benefit from the use of aptitude tests, or career testing. Career testing is often done online and provides insightful and relatively objective information about which jobs may be suitable for the test taker based on combination of their interests, values and skills. Career tests usually provide a list of recommended jobs that match the test
  19. 19. COUNSELLING AND GUIDANCE ABINAYA.T., MSW Page 19 takers attributes with those of people with similar personalities who enjoy/are successful at their jobs. There are various ways to test an individual for which field he is suitable, psychometric testing being one among them. Psychometric testing covers a wide range of skills, interests and values of people and can be of use in career Counselling in different ways. For example, the information won from such tests can be of help for the professionals who mentor, coach or counsel individuals. With psychometric testing, there is no pass or fail, but the quality of the information won from the tests can vary. Psychometric testing uses in-depth psychological profiles to assess personality and intellectual levels. Different test companies use different theoretical approaches to testing, such as the psychometric approach, the psychodynamic approach, the social learning approach and the humanist approach. Different test companies have their own methods of testing, some of them being protected with copyrights. Two commonly used assessments are the Strong Interest Inventory and the MBTI, for example. Usually, psychometric testing uses multiple sets of questions relating to personality type, how the test taker would handle aspects of work and home life, what his or her goals are for the future and his or her strengths and weaknesses. If the test taker is honest and the employed tests follow scientific standards, the results should be fairly accurate and useful for career Counselling activities. Challenges One of the major challenges associated with career Counselling is encouraging participants to engage in the process. For example in the UK 70% of people under 14 say they have had no careers advice while 45% of people over 14 have had no or very poor/limited advice.[11] In a related issue some client groups tend to reject the interventions made by professional career counselors preferring to rely on the advice of peers or
  20. 20. COUNSELLING AND GUIDANCE ABINAYA.T., MSW Page 20 superiors within their own profession. Jackson et al. found that 44% of doctors in training felt that senior members of their own profession were best placed to give careers advice.[12] Furthermore it is recognised that the giving of career advice is something that is widely spread through a range of formal and informal roles. In addition to career counselors it is also common for teachers, managers, trainers and Human Resources(HR) specialists to give formal support in career choices. Similarly it is also common for people to seek informal support from friends and family around their career choices and to bypass career professionals altogether. Today increasingly people rely on career web portals to seek advice on resume writing and handling interviews; as also to research on various professions and companies. It has even become possible to take vocational assessments online. Marital counselling Couples counselling, previously known as marital therapy or marriage guidance, address the problems arising from adult sexual or intimate relationships. The relationship, rather than the two individuals, is the 'client'. Our very closest relationship: a marriage; co-habitation or civil partnership, is based on intimacy and trust. When it stops working we are affected deeply and our health and happiness suffer. Our sense of identity and self-worth often rests on the strength of our relationships and we can despair when our prime relationship fails. Pressures of work, family, money and health all take their toll. Suddenly the relationship that once recharged us leaves us drained and disappointed. Patterns of behaving that we learned as children often re-emerge in our adult relationship. A childhood 'scapegoat' may start to feel blamed for everything by the partner who once adored them.
  21. 21. COUNSELLING AND GUIDANCE ABINAYA.T., MSW Page 21 Signs you have relationship problems  communication breaks down  sex has ended or causes problems  arguments continue without resolution  violence erupts  depression or other health problems recur  the bond of trust is eroded or broken. It is normal for relationships to suffer as the pressure and strains of everyday life mount. Love may disappear, replaced by resentment and anger. Each partner can view this differently depending on their own experience of family life. One may despair, while the other may view it as a temporary blip. Where a couple has attached hastily - in response to a passion, pregnancy or other need, disappointments can surface and fester when the excitement subsides. Renegotiating, with a skilled counsellor, can help build a more realistic and deeper relationship. When is the right time for couple counselling?  There has been a betrayal of trust; an affair, debt or secret.  Talking causes confusion or unbearable anger.  Separation or Divorce seem like the only option.  Desire has gone or sex is no fun.  Arguments and bickering go on and on. If possible, attend together unless there is domestic violence or fear. Counselling can be undertaken with one partner if that feels more comfortable.
  22. 22. COUNSELLING AND GUIDANCE ABINAYA.T., MSW Page 22 Being able to manage conflict, arguments and rows is the foundation stone to a good relationship. It is unrealistic to hope that arguments can be avoided. Two people come with their own values and beliefs and both must feel heard in order to thrive. This may mean developing new skills. Differences need to be acknowledged; otherwise we merge or one partner is unheard. Then one partner may dominate and the other 'disappears'. Arguments are a healthy and essential part of any relationship and can energise it if carried out skilfully. Indirect anger and domestic violence are destructive. Counselling can help with understanding the messages about conflict that we may have inherited from our family and offer new skills. Causes of relationship problems  lack of negotiation can shatter expectations  stress can fracture a relationship  illness can deplete both partners  birth of a child can leave a partner feeling abandoned  depression can leave a partner feeling deserted  external pressures can sever the couple bond  disappointment can lead to anger and hostility  life changes  children leaving home can allow resentments to resurface. Relationships need solid foundations; two unhappy people with unresolved issues rarely make a long-term happy relationship. It may be tempting to feel
  23. 23. COUNSELLING AND GUIDANCE ABINAYA.T., MSW Page 23 that our partner or colleague can compensate for earlier pain and loss, but this hope often leads to further disappointment. Enter a relationship as healthily as possible for the best chance of long-term happiness. The pleasure is in wanting to be with someone rather than the tension of feeling needy and dependent. Self-respect and liking oneself are the important ingredients for a good relationship. If they are in short supply you may consider counselling to address them. Individual work or bereavement counselling may help you move on following a separation or bereavement. How can couples counselling help?  Destructive patterns of relating can be recognised and addressed.  Conflict and communication can be improved.  New relationship skills can be learned.  The impact of change and loss can be examined.  Relationships can be more successful.  Abusive relationships and domestic violence can be acknowledged. Sex can be a source of great enjoyment within a long-term relationship and any problems it poses can leave one partner feeling rejected or angry. Loss of desire is often an early sign of problems. Psychosexual issues can highlight a problem within the relationship or arise from the past. Childhood sexual abuse, for example, can impact on an otherwise happy relationship and can be helped with a suitably qualified practitioner. Other sexual problems may have a physical or medical cause, but can often be addressed with a good therapist.
  24. 24. COUNSELLING AND GUIDANCE ABINAYA.T., MSW Page 24 Communicating and staying connected during difficult times may feel impossible. When two people no longer relate, their relationship is in crisis. Often a betrayal of some type follows; an affair or a secret debt as the breakdown is acted out. Skills are available to help you listen and be heard, particularly when the unbearable needs to be heard and acknowledged. This is the classic time when couples seek help. A new depth of understanding can be reached or a couple may feel they must separate or divorce. Separation & divorce counselling can help explore whether trust can be repaired or the relationship will need to be rebuilt. If not, it can allow the couple to split with more understanding and less hostility. Sex Therapy Relationship problems can arise from sexual difficulties, but sexual problems may also be an indication of deeper problems in the relationship. Sexual difficulties can emerge at any time, but especially in times of stress and change. Sex essentially is fun and can be one of the great rewards of being together. While one partner may use the frequency of sex to gauge how he or she is loved and valued, the other may have intimacy as the benchmark. When a couple have 'gone off' sex, it can reveal their deeper attitude to trust, love and control. Is the problem about unsatisfactory sex or does the sexual problem indicate a deeper issue that needs to be explored? Emotional trust is the foundation stone of physical intimacy. Signs of a relationship sex issue o Sex is no longer on the agenda. o Sex is difficult or painful for one partner. o Sex causes disappointment. o One partner has gone off sex.
  25. 25. COUNSELLING AND GUIDANCE ABINAYA.T., MSW Page 25 Families pass on unspoken messages about sex which can cause unnecessary distress in couples. Often individuals need to explore their own sexuality away from such pressures. What feels good and what feels disappointing? Attitudes inherited from childhood or out of ignorance can cause unnecessary misery. Cultural pressure may require a detached and analytical re-examination to allow a couple to make their own rules. Sometimes traumatic sexual experiences from childhood or past relationships can emerge in a present relationship. With trust these can be explored and resolved. Causes of sex issues o physical – due to alcohol, drugs or illness o pregnancy o aging or loss of self-esteem o anxieties and Stress o loss of status or change in circumstances o betrayal of trust. How can counselling help sex issues? Relationship counselling can help explore the physical communication and the understanding of what sex means to two particular people. Sex may be mechanical and a way to maintain a safe distance for one person. In such cases, the partner may mourn the lack of intimacy and trust which would allow them to feel safe and enjoy sex. Withdrawal of sex can happen when a person has no alternative way to express their anger and disappointment – so the forbidden feelings are acted out in the bedroom. Control and power are often issues in difficult sexual relationships as
  26. 26. COUNSELLING AND GUIDANCE ABINAYA.T., MSW Page 26 one partner may be unconsciously exerting the control and power they feel they lack outside the bedroom. If the problem is around a dysfunction, a couple can be referred for psychosexual therapy with a suitably qualified person. Family therapy Family therapy, also referred to as couple and family therapy, marriage and family therapy, family systems therapy, and family Counselling, is a branch of psychotherapy that works with families and couples in intimate relationships to nurture change and development. It tends to view change in terms of the systems of interaction between family members. It emphasizes family relationships as an important factor in psychological health. The different schools of family therapy have in common a belief that, regardless of the origin of the problem, and regardless of whether the clients consider it an "individual" or "family" issue, involving families in solutions often benefits clients. This involvement of families is commonly accomplished by their direct participation in the therapy session. The skills of the family therapist thus include the ability to influence conversations in a way that catalyses the strengths, wisdom, and support of the wider system. In the field's early years, many clinicians defined the family in a narrow, traditional manner usually including parents and children. As the field has evolved, the concept of the family is more commonly defined in terms of strongly supportive, long-term roles and relationships between people who may or may not be related by blood or marriage. The conceptual frameworks developed by family therapists, especially those of family systems theorists, have been applied to a wide range of human behaviour, includingorganisational dynamics and the study of greatness.
  27. 27. COUNSELLING AND GUIDANCE ABINAYA.T., MSW Page 27 UNIT 3 Psychoanalytic theory Sigmund Freud Psychoanalytic theory refers to the definition of personality organization and the dynamics of personality development that underlie and guide the psychoanalytic and psycho dynamic psychotherapy, called psychoanalysis, a clinical method for treating psychopathology. First laid out by Sigmund Freud in the late 19th century, psychoanalytic theory has undergone many refinements since his work. Psychoanalytic theory came to full prominence in the last third of the twentieth century as part of the flow of critical discourse regarding psychological treatments after the 1960s, long after Freud's death in 1939, and its validity is now widely disputed or rejected. Freud had ceased his analysis of the brain and his physiological studies and shifted his focus to the study of the mind and the related psychological attributes making up the mind, and on treatment using free association and the phenomena of transference. His study emphasized the recognition of childhood events that could potentially
  28. 28. COUNSELLING AND GUIDANCE ABINAYA.T., MSW Page 28 influence the mental functioning of adults. His examination of the genetic and then the developmental aspects gave the psychoanalytic theory its characteristics.[6] Starting with his publication of The Interpretation of Dreams in 1899, his theories began to gain prominence. Definition Through the scope of a psychoanalytic lens, humans are described as having sexual and aggressive drives. Psychoanalytic theorists believe that human behavior is deterministic. It is governed by irrational forces, and the unconscious, as well instinctual and biological drives. Due to this deterministic nature, psychoanalytic theorists do not believe in free will. The Beginnings Freud first began his studies on psychoanalysis and in collaboration with Dr. Josef Breuer, especially when it came to the study on Anna O. [8] The relationship between Freud and Breuer was a mix of admiration and competition, based on the fact that they were working together on the Anna O. case and must balance two different ideas as to her diagnosis and treatment. Today, Breuer can be considered the grandfather of psychoanalysis.[9] Anna O. was subject to both physical and psychological disturbances, such as not being able to drink out of fear.[10] Breuer and Freud both found that hypnosis was a great help in discovering more about Anna O. and her treatment. The research and ideas behind the study on Anna O. was highly referenced in Freud's lectures on the origin and development of psychoanalysis. These observations led Freud to theorize that the problems faced by hysterical patients could be associated to painful childhood experiences that could not be recalled. The influence of these lost memories shaped the feelings, thoughts and behaviours of patients. These studies contributed to the development of the psychoanalytic theory.
  29. 29. COUNSELLING AND GUIDANCE ABINAYA.T., MSW Page 29 Personality Structure Sigmund Freud determined that the personality consists of three different elements, the id, the ego and the superego. The id is the aspect of personality that is driven by internal and basic drives and needs. These are typically instinctual, such as hunger, thirst, and the drive for sex, or libido. The id acts in accordance with the pleasure principle, in that it avoids pain and seeks pleasure. Due to the instinctual quality of the id, it is impulsive and often unaware of implications of actions. The ego is driven by reality principle. The ego works to balance both the id and superego. In order to balance these, it works to achieve the id's drive in the most realistic ways. It seeks to rationalize the id's instinct and please the drives that will benefit the individual in the long term. It helps separate what is real, and realistic of our drives as well as being realistic about the standards that the superego sets for the individual. The superego is driven by morality principle. It acts in connection with the morality of higher thought and action. Instead of instinctively acting like the id, the superego works to act in socially acceptable ways. It employs morality, judging our sense of wrong and right and using guilt to encourage socially acceptable behavior. The Unconscious The unconscious is the portion of the mind of which a person is not aware. Freud said that it is the unconscious that exposes the true feelings, emotions, and thoughts of the individual. There are variety of psychoanalytic techniques used to access and understand the unconscious, ranging from methods like hypnosis, free association, dream analysis. Dreams allow us to explore the unconscious; according to Freud, they are "the 'royal road' to the unconscious". Dreams are composed of latent and manifest content. Whereas latent content is the underlying meaning of a dream that may not be remembered when a person wakes up, manifest content is the content from the
  30. 30. COUNSELLING AND GUIDANCE ABINAYA.T., MSW Page 30 dream that a person remembers upon waking and can be analyzed by a psychoanalytic psychologist. Exploring and understanding the manifest content of dreams can inform the individual of complexes or disorders that may be under the surface of their personality. Dreams can provide access to the unconscious that is not easily accessible. Freudian slips (also known as parapraxes) occurs when the ego and superego do not work properly, exposing the id and internal drives or wants. They are considered mistakes revealing the unconscious. Examples range from calling someone by the wrong name, misinterpreting a spoken or written word, or simply saying the wrong thing. Defense Mechanisms The ego balances the id, the superego and reality in order to maintain a healthy state of consciousness. It thus reacts to protect the individual from any stressors and anxiety by distorting reality. This prevents threatening unconscious thoughts and material from entering the consciousness. The different types of defensemechanisms are: Repression,reaction, denial, projection, displacement, sublimation, regression, and rationalization. Psychology theories Psychosexual development Freud's take on the development of the personality (psyche). It is a stage theory that believes progress occurs through stages as the libido is directed to different body parts. The different stages, listed in order of progression, are: Oral, Anal, Phallic (Oedipus complex), Latency, Genital. The Genital stage is achieved if a person has met all of his or her needs throughout the other stages with enough
  31. 31. COUNSELLING AND GUIDANCE ABINAYA.T., MSW Page 31 available sexual energy. If the individual does not have his or her needs met in a given stage, he or she will become fixated, or "stuck" in that stage. Neo-analytic theory Freud's theory and work with psychosexual development lead to Neo- Analytic/ Neo-Freudians who also believed in the importance of the unconscious, dream interpretations, defense mechanisms and the integral influence childhood experiences but had objections to the theory as well. They do not support the idea that development of the personality stops at age 6, instead they believed development spreads across the lifespan. They extended Freud's work and encompassed more influence from the environment and the importance of conscious thought along with the unconscious. The most important theorists are Erik Erikson (Psychosocial Development), Anna Freud, Carl Jung, Alfred Adler and Karen Horney, and including the school of object relations. Classical Adlerian psychotherapy Classical Adlerian psychotherapy may involve individual psychotherapy, couple therapy, or family therapy, brief or lengthier therapy - but all such approaches follow parallel paths, which are rooted in the individual psychology of Alfred Adler. Adler's psychotherapy Adler's therapy involved identifying an individual's private life plan, explaining its self-defeating, useless and predictable aspects, and encouraging a shift of interest towards social and communal goals. Among the specific techniques used were paradoxes, humorous or historical examples, analysis of the self- protective role of symptoms, and reduction of transference by encouraging self- responsibility. Adler also favoured what has been called 'prescribing the
  32. 32. COUNSELLING AND GUIDANCE ABINAYA.T., MSW Page 32 symptom' - a form of anti-suggestion aimed at making the client's self-defeating behavior less attractive to them. Based on a growth model of the mind, Adler's approach aimed at fostering social interest, and reducing repetitive life styles based on archaic private logic. With its emphasis on reasoning with the patient, classical Adlerian therapy has affinities with the later approach of Cognitive behavioral therapy. History of Classical Adlerian Psychotherapy Alfred Adler was greatly influenced by early socialism and Freud. This can be seen in his early work and theories. He emphasized that individuals themselves can change their lives. Adler and Freud respected one another; however, Adler did not fully agree or accept Freud’s theories. Adler believed childhood experiences have influences on people’s current problems, but he also did not believe they are the only contributions. He also emphasizes free will and an inborn drive as contributors to current problems people face. He doesn’t believe individuals are victims of their past experiences. Classical Adlerian Psychotherapy Adlerian psychotherapy is unique in the sense that each client has their own individual type of therapy. The therapy, however, is created by the therapist on a six phase process. The overall goal of the therapy is to establish a relationship between client and community in order not only to challenge the client's unhealthy and unrealistic thoughts of the world, but also to challenge them to replace self-defeating behaviors for ones that will lead to a more positive and healthy lifestyle. Phase 1 This stage focuses on support and is broken down into two stages. The first stage emphasizes empathy and relationships. The therapist provides warmth,
  33. 33. COUNSELLING AND GUIDANCE ABINAYA.T., MSW Page 33 acceptance, and generate hope while giving reassurance and encouragement to the client. The second stage in this phase is focused on gathering information on the client. Early childhood memories and influences are sought out as well as details that provide information on how the client faces life problems. Phase 2 The primary focus in phase two is on encouragement. This is done through two stages of clarification and encouragement. Therapists clarify any vague thinking with Socratic questioning and evaluate the consequences of various actions or ideas. They help the client correct inappropriate ideas about his or her self and others. They also help the client create alternative ways of thinking to move his/her life into a new direction while clarifying feelings. Phase 3 Insight is the headline for phase 3. Interpretation and recognition, as well as knowing are the focus of the Insight phase. The client will learn to interpret his/her feelings and goals as well as identify what s/he has avoided in the past. This stage integrates many Freudian ideas such as dreams, daydreams, and recollections. The Knowing stage is where the client is now fully aware of his/her lifestyle and does not require any additional help with this. They know and accept what they need to change. Phase 4 The fourth phase is all about change. Change is first addressed through the stage of an Emotional Breakthrough. This can be achieved through the use of role playing, guided imagery and narration. The next stage is Doing Differently. The client will break old patterns and change their attitude. This is achieved through creating steps which are based on abstract ideas. The last stage in this phase is Reinforcement. The therapist will encourage all efforts made by the client to
  34. 34. COUNSELLING AND GUIDANCE ABINAYA.T., MSW Page 34 promote change. They will reward and affirm positive feelings and changes while simultaneously evaluating the progress made by the client. Phase 5 The final phase is about Challenge. The client goes through a first stage which is characterized by social interest. S/he is instructed to give 100% in all relationships and is encouraged to take risks. S/he is required to extend new feelings of cooperation and empathy to others. Then, through goal redirection, the client is challenged to release his/her old self and open a new self and live by these new values. The last and final stage is focused on support and launching. The therapist will inspire the client to enjoy the unfamiliar, strengthen their feelings of connectedness to others, and to continue self growth. Phase 6 The Meta-Therapy phase is for clients who have gone through Alder’s therapy, readjusted their lives to better suit their goals, and who are making progress in becoming who they want to be. This ending part of the therapy advises clients to find out what aspects of life are truly important to them, and to pursue these”higher values”. Uses of Classical Adlerian Psychotherapy 1. Individual The basic structure of individual therapy in Classical Adlerian psychotherapy is broken down into 5 phases plus a post-therapy follow up, and each phase is broken down into multiple stages, 13 total. Each of these stages has different goals for the client and therapist to accomplish. This is the type of therapy Classical Adlerian Psychotherapy was designed for.
  35. 35. COUNSELLING AND GUIDANCE ABINAYA.T., MSW Page 35 2. Teacher-education Programs Teacher-education programs have been designed to increase child cooperation in classrooms. Teachers, parents, and school administrators attend these programs and learn techniques to increase their own teaching effectiveness in the classroom as well as how to learn to better handle children. These programs are taught in the same manner that marital programs are taught. 3. Couple-enrichment Programs Similar to group couple Counselling, couple-enrichment programs are conducted by trained professionals and have groups of couples (typically about 10) attend and learn how to improve and enrich their relationships. Many different teaching formats are used that include tools such as role playing, the viewing of videos, and the implementation of other psycho-social exercises. Sessions run for about an hour’s time. 4. Parent and Family Education Programs These programs are comparable to classes taught by Family Life Educators. The programs focus on building better family relaitonships. Existential therapy Existential psychotherapy is a philosophical method of therapy that operates on the belief that inner conflict within a person is due to that individual's confrontation with the givens of existence. These givens, as noted by Irvin D. Yalom, are: the inevitability of death, freedom and its attendant responsibility, existential isolation (referring tophenomenology), and finally meaninglessness. These four givens, also referred to as ultimate concerns, form the body of existential psychotherapy and compose the framework in which a therapist conceptualizes a client's problem in order to develop a method of treatment. In the British School of Existential therapy (Cooper, 2003), these givens are seen
  36. 36. COUNSELLING AND GUIDANCE ABINAYA.T., MSW Page 36 as predictable tensions and paradoxes of the four dimensions of human existence, the physical, social, personal and spiritual realms. Psychological dysfunction Because there is no single existential view, opinions about psychological dysfunction vary. For theorists aligned with Yalom, psychological dysfunction results from the individual's refusal or inability to deal with the normal existential anxiety that comes from confronting life's "givens": mortality, isolation, meaninglessness, and freedom. For other theorists, there is no such thing as psychological dysfunction or being mentally ill. Every way of being is merely an expression of how one chooses to live one's life. However, one may feel unable to come to terms with the anxiety of being alone in the world. If so, an existential psychotherapist can assist one in accepting these feelings rather than trying to change them as if there is something wrong. Everyone has the freedom to choose how they are going to be in life, however this may go unexercised because making changes is difficult; it may appear easier and safer not to make decisions that one will be responsible for. Many people will remain unaware of alternative choices in life for various societal reasons. The good life Existentialism suggests that it is possible for people to face the anxieties of life head-on and embrace the human condition of aloneness, to revel in the freedom to choose and take full responsibility for their choices. They courageously take the helm of their lives and steer in whatever direction they choose; they have the courage to be. One does not need to arrest feelings of meaninglessness, but can choose new meanings for their lives. By building, by loving, and by creating one is able to live life as one's own adventure. One can accept one's own
  37. 37. COUNSELLING AND GUIDANCE ABINAYA.T., MSW Page 37 mortality and overcome fear of death. Though the French author Albert Camus denied the specific label of existentialist, in his novel, L'Etranger, his main character Meursault, ends the novel by doing just this. He accepts his mortality and rejects the constrictions of society he previously placed on himself, leaving him unencumbered and free to live his life with an unclouded mind. Existential therapy The existential psychotherapist is generally not concerned with the client's past; instead, the emphasis is on the choices to be made in the present and future. The counselor and the client may reflect upon how the client has answered life's questions in the past, but attention ultimately shifts to searching for a new and increased awareness in the present and enabling a new freedom and responsibility to act. The patient can then accept they are not special, and that their existence is simply coincidental, without destiny or fate. By accepting this, they can overcome their anxieties, and instead view life as moments in which they are fundamentally free. (The outline above is based on a strictly Sartrean perspective) Four worlds Existential thinkers seek to avoid restrictive models that categorize or label people. Instead they look for the universals that can be observed cross- culturally. There is no existential personality theory which divides humanity into types or reduces people to part components. Instead there is a description of the different levels of experience and existence with which people are inevitably confronted. The way in which a person is in the world at a particular stage can be charted on this general map of human existence (Binswanger, 1963; Yalom, 1980; van Deurzen, 1984). One can distinguish four basic dimensions of human existence: the physical, the social, the psychological and the spiritual. On each
  38. 38. COUNSELLING AND GUIDANCE ABINAYA.T., MSW Page 38 of these dimensions people encounter the world and shape their attitude out of their particular take on their experience. Their orientation towards the world defines their reality. The four dimensions are obviously interwoven and provide a complex four-dimensional force field for their existence. Individuals are stretched between a positive pole of what they aspire to on each dimension and a negative pole of what they fear. Physical dimension On the physical dimension (Umwelt) individuals relate to their environment and to the givens of the natural world around them. This includes their attitude to the body they have, to the concrete surroundings they find themselves in, to the climate and the weather, to objects and material possessions, to the bodies of other people, their own bodily needs, to health and illness and to their own mortality. The struggle on this dimension is, in general terms, between the search for domination over the elements and natural law (as in technology, or in sports) and the need to accept the limitations of natural boundaries (as in ecology or old age). While people generally aim for security on this dimension (through health and wealth), much of life brings a gradual disillusionment and realization that such security can only be temporary. Recognizing limitations can bring great release of tension. Social dimension On the social dimension (Mitwelt) individuals relate to others as they interact with the public world around them. This dimension includes their response to the culture they live in, as well as to the class and race they belong to (and also those they do not belong to). Attitudes here range from love to hate and from cooperation to competition. The dynamic contradictions can be understood in terms of acceptance versus rejection or belonging versus isolation. Some people prefer to withdraw from the world of others as much as possible. Others blindly chase public acceptance by going along with the rules and fashions of the moment. Otherwise they try to rise above these by becoming trendsetters themselves. By acquiring fame or other forms of power, individuals
  39. 39. COUNSELLING AND GUIDANCE ABINAYA.T., MSW Page 39 can attain dominance over others temporarily. Sooner or later, however, everyone is confronted with both failure and aloneness. Psychological dimension On the psychological dimension (Eigenwelt) individuals relate to themselves and in this way create a personal world. This dimension includes views about their own character, their past experience and their future possibilities. Contradictions here are often experienced in terms of personal strengths and weaknesses. People search for a sense of identity, a feeling of being substantial and having a self. But inevitably many events will confront them with evidence to the contrary and plunge them into a state of confusion or disintegration. Activity and passivity are an important polarity here. Self-affirmation and resolution go with the former and surrender and yielding with the latter. Facing the final dissolution of self that comes with personal loss and the facing of death might bring anxiety and confusion to many who have not yet given up their sense of self-importance. Spiritual dimension On the spiritual dimension (Überwelt) (van Deurzen, 1984) individuals relate to the unknown and thus create a sense of an ideal world, an ideology and a philosophical outlook. It is here that they find meaning by putting all the pieces of the puzzle together for themselves. For some people this is done by adhering to a religion or other prescriptive world view, for others it is about discovering or attributing meaning in a more secular or personal way. The contradictions that have to be faced on this dimension are often related to the tension between purpose and absurdity, hope and despair. People create their values in search of something that matters enough to live or die for, something that may even have ultimate and universal validity. Usually the aim is the conquest of a soul, or something that will substantially surpass mortality (as for instance in having contributed something valuable to humankind). Facing the void and the possibility of nothingness are the indispensable counterparts of this quest for the eternal.
  40. 40. COUNSELLING AND GUIDANCE ABINAYA.T., MSW Page 40 Person-centered therapy Person-centered therapy (PCT) is also known as person-centered psychotherapy, person-centered Counselling, client-centered therapy and Rogerian psychotherapy. PCT is a form of talk- psychotherapy developed by psychologist Carl Rogers in the 1940s and 1950s. The goal of PCT is to provide clients with an opportunity to develop a sense of self wherein they can realize how their attitudes, feelings and behavior are being negatively affected. Although this technique has been criticized by behaviorists for lacking structure and by psychoanalysts for actually providing a conditional relationship[2] it has proven to be an effective and popular treatment. History and influences Person-centered therapy, now considered a founding work in the humanistic school of psychotherapies, began formally with Carl Rogers. "Rogerian" psychotherapy is identified as one of the major school groups, along with psychodynamic psychotherapy, psychoanalysis (most famously Sigmund Freud), classical Adlerian psychology, cognitive behavioral therapy, and existential therapy (such as that pioneered by Rollo May).[8] Rogers affirmed individual personal experience as the basis and standard for living and therapeutic effect. Rogers identified six conditions which are needed to produce personality changes in clients: relationship, vulnerability to anxiety (on the part of the client), genuineness (the therapist is truly himself or herself and incorporates some self-disclosure), the client's perception of the therapist's genuineness, the therapist's unconditional positive regard for the client, and accurate empathy.[9] This emphasis contrasts with the dispassionate position which may be intended in other therapies, particularly the more extreme behavioral therapies. Living in the present rather than the past or future, with
  41. 41. COUNSELLING AND GUIDANCE ABINAYA.T., MSW Page 41 organismic trust, naturalistic faith in your own thoughts and the accuracy in your feelings, and a responsible acknowledgment of your freedom, with a view toward participating fully in our world, contributing to other peoples' lives, are hallmarks of Roger's Person-centered therapy. Rogers also claims that the therapeutic process is essentially the accomplishments made by the client. The client having already progressed further along in their growth and maturation development, only progresses further with the aid of a psychologically favored environment.[10] Core Conditions Rogers (1957; 1959) stated[9] that there are six necessary and sufficient conditions required for therapeutic change: 1. Therapist-Client Psychological Contact: a relationship between client and therapist must exist, and it must be a relationship in which each person's perception of the other is important. 2. Client in-congruence: that in-congruence exists between the client's experience and awareness. 3. Therapist Congruence, or Genuineness: the therapist is congruent within the therapeutic relationship. The therapist is deeply involved him or herself - they are not "acting" - and they can draw on their own experiences (self-disclosure) to facilitate the relationship. 4. Therapist Unconditional Positive Regard (UPR): the therapist accepts the client unconditionally, without judgment, disapproval or approval. This facilitates increased self-regard in the client, as they can begin to become aware of experiences in which their view of self-worth was distorted by others. 5. Therapist Empathic understanding: the therapist experiences an empathic understanding of the client's internal frame of reference.
  42. 42. COUNSELLING AND GUIDANCE ABINAYA.T., MSW Page 42 Accurate empathy on the part of the therapist helps the client believe the therapist's unconditional love for them. 6. Client Perception: that the client perceives, to at least a minimal degree, the therapist's UPR and empathic understanding. Processes Rogers asserted that the most important factor in successful therapy is the relational climate created by the therapist's attitude to their client. He specified three interrelated core conditions: 1. Congruence - the willingness to transparently relate to clients without hiding behind a professional or personal facade. 2. Unconditional Positive Regard - the therapist offers an acceptance and prizing for their client for who he or she is without conveying disapproving feelings, actions or characteristics and demonstrating a willingness to attentively listen without interruption, judgement or giving advice. 3. Empathy - the therapist communicates their desire to understand and appreciate their clients perspective. Rogers believed that a therapist who embodies these three critical attitudes will help liberate their client to more confidently express their true feelings without fear of judgement. To achieve this, the client-centered therapist carefully avoids directly challenging their client's way of communicating themselves in the session in order to enable a deeper exploration of the issues most intimate to them and free from external referencing.[11] Rogers was not prescriptive in telling his clients what to do, but believed that the answers to the patients' questions were within the patient and not the therapist. Accordingly the therapists' role was to create a facilitative, empathic environment wherein the patient could discover the answers for him or herself.
  43. 43. COUNSELLING AND GUIDANCE ABINAYA.T., MSW Page 43 UNIT 4 Rational Emotive Behaviour Therapy Psychologist Albert Ellis created Rational Emotive Behavior Therapy, also known as REBT. Rational emotive behavior therapy, also known as REBT, is a type of cognitive- behavioral therapy developed by psychologist Albert Ellis. REBT is focused on helping clients change irrational beliefs. History of Rational Emotive Behavior Therapy Ellis had trained as a clinical psychologist. As he treated patients, he became increasingly dissatisfied with the results offered by traditional psychoanalytic therapy. He noted that while his patients were able to become aware of their underlying problems, their behavior did not actually change. By the 1950s, Ellis had started experimenting with other types of psychotherapy and was heavily influenced by philosophers and psychologists including Karen Horney and Alfred Adler as well as the work of behavioral therapists. Ellis's goal was to develop an action-oriented approach to psychotherapy designed to
  44. 44. COUNSELLING AND GUIDANCE ABINAYA.T., MSW Page 44 produce results by helping clients manage their emotions, cognitions, and behaviors. According to Ellis, "people are not disturbed by things but rather by their view of things." The fundamental assertion of Rational Emotive Therapy is that the way people feel is largely influenced by how they think. When people hold irrational beliefs about themselves or the world, problems result. Because of this, the goal of REBT is to help people alter illogical beliefs and negative thinking patterns in order to overcome psychological problems and mental distress. Rational emotive behavior therapy was one of the very first types of cognitive therapies. Ellis first began developing REBT during the early 1950s and initially called his approach rational therapy. In 1959, the technique was redubbed rational emotive therapy and later rechristened rational emotive behavior therapy in 1992. Ellis continued to work on REBT until his death in 2007. The ABC Model Ellis suggested that people mistakenly blame external events for unhappiness. He argued, however, that it is our interpretation of these events that truly lies at the heart of our psychological distress. To explain this process, Ellis developed what he referred to as the ABC Model:  A – Activating Event: Something happens in the environment around you.  B – Beliefs: You hold a belief about the event or situation.  C – Consequence: You have an emotional response to your belief.
  45. 45. COUNSELLING AND GUIDANCE ABINAYA.T., MSW Page 45 The Basic Steps in Rational Emotive Behavior Therapy 1. Identifying the underlying irrational thought patterns and beliefs. The very first step in the process is to identify the irrational thoughts, feelings, and beliefs that lead to psychological distress. In many cases, these irrational beliefs are reflected as absolutes, as in "I must," "I should," or "I cannot." According to Ellis, some of the most common irrational beliefs include:  Feeling excessively upset over other people's mistakes or misconduct.  Believing that you must be 100 percent competent and successful in everything to be valued and worthwhile.  Believing that you will be happier if you avoid life's difficulties or challenges.  Feeling that you have no control over your own happiness; that your contentment and joy are dependent upon external forces. By holding such unyielding beliefs, it becomes almost impossible to respond to situations in a psychologically healthy way. Possessing such rigid expectations of ourselves and others only leads to disappointment, recrimination, regret, and anxiety. 2. Challenging the irrational beliefs. Once these underlying feelings have been identified, the next step is to challenge these mistaken beliefs. In order to do this, the therapist must dispute these beliefs using very direct and even confrontational methods. Ellis suggested that rather than simply being warm and supportive, the therapist needs to be blunt, honest, and logical in order to push people toward changing their thoughts and behaviors.
  46. 46. COUNSELLING AND GUIDANCE ABINAYA.T., MSW Page 46 3. Gaining Insight and Recognizing Irrational Thought Patterns As you might imagine, REBT can be a daunting process for the client. Facing irrational thought patterns can be difficult, especially because accepting these beliefs as unhealthy is far from easy. Once the client has identified the problematic beliefs, the process of actually changing these thoughts can be even more difficult. While it is perfectly normal to feel upset when you make a mistake, the goal of REBT is to help people respond rationally to such situations. When faced with this type of situation in the future, the emotionally healthy response would be to realize that while it would be wonderful to be perfect and never make mistakes, it is not realistic to expect success in every endeavor. You made a mistake. But that's okay because everyone makes mistakes. All you can do is learn from the situation and move on. It is also important to recognize that while rational emotive behavior therapy utilizes cognitive strategies to help clients, it also focuses on emotions and behaviors as well. In addition to identifying and disputing irrational beliefs, therapists and clients also work together to target the emotional responses that accompany problematic thoughts. Clients are also encouraged to change unwanted behaviors using such things as meditation, journaling, and guided imagery. REBT can be effective in the treatment of a range of psychological disorders including anxiety disorders and phobias as well as specific behaviors such as severe shyness and excessive approval seeking.
  47. 47. COUNSELLING AND GUIDANCE ABINAYA.T., MSW Page 47 Behavioural Therapy Behavioral therapy is a treatment that helps change potentially self-destructing behaviors. It is also called behavioral modification or cognitive behavioral therapy. Medical professionals use this type of therapy to replace bad habits with good ones. The therapy also helps you cope with difficult situations. It is most often used to treat anxiety disorders. However, you don’t have to be diagnosed with a mental health disorder to benefit. What Is Behavioral Therapy Used For? Behavioral therapy is used by psychotherapists, psychiatrists, and other qualified medical professionals. It is usually used to help treat anxiety and mood disorders. These include:  obsessive-compulsive disorder (OCD)  post-traumatic stress disorder (PTSD)  depression  social phobia  bipolar disorder  schizophrenia
  48. 48. COUNSELLING AND GUIDANCE ABINAYA.T., MSW Page 48 This treatment can help patients cope with certain mental disorders. It can also be used to treat:  autism  personality disorders  substance abuse  eating disorders This therapy is also used on patients with chronic diseases to help manage pain. For example, cancer patients use learned techniques to better copewith radiation therapy. Doctors often recommend behavioral modification to pregnant women who can’t safely take medications. This form of treatment can also help with emotional grief. Techniques Used Therapists create treatment plans specifically tailored to individual conditions. Some exercises may include:  discussions about coping mechanisms  role playing  breathing and relaxation methods  positive reinforcement  activities to promote focus  journal writing  social skills training  modifications in responses to anger, fear, and pain Therapists sometimes ask patients to think about situations that scare them. The goal is not to frighten them but to help them develop different coping skills
  49. 49. COUNSELLING AND GUIDANCE ABINAYA.T., MSW Page 49 Benefits The general benefit is increased quality of life. Specific benefits vary depending on what condition is being treated. These can include:  reduced incidents of self-harm  improved social skills  better functioning in unfamiliar situations  improved emotional expressions  less outbursts Cognitive Behavior Therapy Dr. Aaron Beck Cognitive behavior therapy (CBT) is a type of psychotherapeutic treatment that helps patients understand the thoughts and feelings that influence behaviors. CBT is commonly used to treat a wide range of disorders including phobias, addiction, depression and anxiety. Cognitive behavior therapy is generally short-term and focused on helping clients deal with a very specific problem. During the course of treatment, people
  50. 50. COUNSELLING AND GUIDANCE ABINAYA.T., MSW Page 50 learn how to identify and change destructive or disturbing thought patterns that have a negative influence on behavior. Cognitive Behavior Therapy Basics The underlying concept behind CBT is that our thoughts and feelings play a fundamental role in our behavior. For example, a person who spends a lot of time thinking about plane crashes, runway accidents, and other air disasters may find themselves avoiding air travel. The goal of cognitive behavior therapy is to teach patients that while they cannot control every aspect of the world around them, they can take control of how they interpret and deal with things in their environment. Cognitive behavior therapy has become increasingly popular in recent years with both mental health consumers and treatment professionals. Because CBT is usually a short-term treatment option, it is often more affordable than some other types of therapy. CBT is also empirically supported and has been shown to effectively help patients overcome a wide variety of maladaptive behaviors. Types of Cognitive Behavior Therapy According to the British Association of Behavioural and Cognitive Psychotherapies, "Cognitive and behavioural psychotherapies are a range of therapies based on concepts and principles derived from psychological models of human emotion and behaviour. They include a wide range of treatment approaches for emotional disorders, along a continuum from structured individual psychotherapy to self help material." There are a number of different approaches to CBT that are regularly used by mental health professionals. These types include:
  51. 51. COUNSELLING AND GUIDANCE ABINAYA.T., MSW Page 51  Rational Emotive Therapy  Cognitive Therapy  Multimodal Therapy The Components of Cognitive Behavior Therapy People often experience thoughts or feelings that reinforce or compound faulty beliefs. Such beliefs can result in problematic behaviors that can affect numerous life areas, including family, romantic relationships, work, and academics. For example, a person suffering from low self-esteem might experience negative thoughts about his or her own abilities or appearance. As a result of these negative thinking patterns, the individual might start avoiding social situations or pass up opportunities for advancement at work or at school. In order to combat these destructive thoughts and behaviors, a cognitive- behavioral therapist begins by helping the client to identify the problematic beliefs. This stage, known as functional analysis, is important for learning how thoughts, feelings, and situations can contribute to maladaptive behaviors. The process can be difficult, especially for patients who struggle with introspection, but it can ultimately lead to self-discovery and insights that are an essential part of the treatment process. The second part of cognitive behavior therapy focuses on the actual behaviors that are contributing to the problem. The client begins to learn and practice new skills that can then be put into use in real-world situations. For example, a person suffering from drug addiction might start practicing new coping skills and rehearsing ways to avoid or deal with social situations that could potentially trigger a relapse.
  52. 52. COUNSELLING AND GUIDANCE ABINAYA.T., MSW Page 52 In most cases, CBT is a gradual process that helps a person take incremental steps towards abehavior change. Someone suffering from social anxiety might start by simply imagining himself in an anxiety-provoking social situation. Next, the client might start practicing conversations with friends, family, and acquaintances. By progressively working toward a larger goal, the process seems less daunting and the goals easier to achieve. Uses of Cognitive Behavior Therapy Cognitive behavior therapy has been used to treat people suffering from a wide range of disorders, including anxiety, phobias, depression, and addiction. CBT is one of the most researched types of therapy, in part because treatment is focused on highly specific goals and results can be measured relatively easily. Cognitive behavior therapy is often best-suited for clients who are comfortable with introspection. In order for CBT to be effective, the individual must be ready and willing to spend time and effort analyzing his or her thoughts and feelings. Such self-analysis can be difficult, but it is a great way to learn more about how internal states impact outward behavior. Cognitive behavior therapy is also well-suited for people looking for a short- term treatment option that does not necessarily involve pharmacological medication. One of the greatest benefits of cognitive-behavior therapy is that it helps clients develop coping skills that can be useful both now and in the future. Criticisms of Cognitive Behavior Therapy Initially, some patients suggest that while they recognize that certain thoughts are not rational or healthy, simply becoming aware of these thoughts does not make it easy to stop having them. It is important to note that CBT does not just
  53. 53. COUNSELLING AND GUIDANCE ABINAYA.T., MSW Page 53 involve identifying these thought patterns; it is focused on using a wide range of strategies to help clients overcome these thoughts. Such strategies may include journaling, role-playing, relaxation techniques, and mental distractions. Reality therapy
  54. 54. COUNSELLING AND GUIDANCE ABINAYA.T., MSW Page 54 Reality therapy (RT) is an approach to psychotherapy and Counselling. Developed by William Glasser in the 1960s, RT differs from conventional psychiatry, psychoanalysis and medical model schools of psychotherapy in that it focuses on what Glasser calls psychiatry's three Rs: realism, responsibility, and right-and-wrong, rather than symptoms of mental disorders. Reality therapy maintains that the individual is suffering from a socially universal human condition rather than a mental illness. It is in the unsuccessful attainment of basic needs that a person's behavior moves away from the norm. Since fulfilling essential needs is part of a person's present life, reality therapy does not concern itself with a client's past. Neither does this type of therapy deal with unconscious mental processes. In these ways reality therapy is very different from other forms of psychotherapy. The reality therapy approach to Counselling and problem-solving focuses on the here-and-now actions of the client and the ability to create and choose a better future. Typically, clients seek to discover what they really want and how they are currently choosing to behave in order to achieve these goals. According to Glasser, the social component of psychological disorders has been highly overlooked in the rush to label the population as sick or mentally ill. Reality therapy attempts to separate the client from the behavior. Just because someone is experiencing distress resulting from a social problem does not make him sick; it just makes him out of sync with his psychological needs. Process of RT Involvement Establishing a relationship with the client is believed to be the most important factor in all types of therapy. Without this relationship, the other steps will not be effective. This is also known as developing a good rapport with the client. In extreme cases, the therapist may be the only person in the client's life who is
  55. 55. COUNSELLING AND GUIDANCE ABINAYA.T., MSW Page 55 willing to put up with the client's behavior long enough to establish a relationship, which can require a great deal of patience from the therapist. In other cases, the client is a part of many relationships, but just needs a relationship with a more consistently positive emphasis. According to Glasser, the client needs to feel that the therapist is someone that he would want in his "Quality World". Evaluating current behavior The therapist must emphasize the here and now with the client, focusing on the current behaviors and attitudes. The therapist asks the client to make a value judgment about his or her current behavior (which presumably is not beneficial, otherwise the client may not have negative consequences from behavior motivating enough to seek therapy). In many cases the therapist must press the client to examine the effects of his or her behavior, but it is important that the judgment be made by the client and not the therapist. According to Glasser, it is important for the client to feel that he is in control of his own life.[14] Planning possible behaviour Plan some behavior that is likely to work better. The client is likely to need some suggestions and prompting from the therapist, but it helps if the plan itself comes from the client. It is important that the initial steps be small enough that the client is almost certain to succeed, in order to build confidence. In many cases, the client's problem is the result of a bad relationship with someone, and since the client cannot change anyone else's behavior, the therapist will focus on things the client can do unilaterally. The client may be concerned that the other person will take advantage of this and not reciprocate, but in most cases a change in behavior will ease the tension enough that the other person also backs off. If this does not happen, the therapist will also encourage the client to build more positive relationships with other people. The relationship with the
  56. 56. COUNSELLING AND GUIDANCE ABINAYA.T., MSW Page 56 therapist sustains the client long enough for them to establish these other relationships. Principles of RT There are several basic principles of reality therapy that must be applied to make this technique most successful. 1. Focus on the present and avoid discussing the past because all human problems are caused by unsatisfying present relationships. 2. Avoid discussing symptoms and complaints as much as possible since these are often the ineffective ways that clients choose to deal with (and hold on to) unsatisfying relationships. 3. Understand the concept of total behavior, which means focus on what clients can do, directly act, and think. *Spend less time on what they cannot do directly such as changing their feelings and physiology. Feelings and physiology can be changed indirectly, but only if there is a change in the acting and thinking. 4. Avoid criticizing, blaming and/or complaining and help clients do the same. By doing this, they learn to avoid these extremely harmful external control behaviors that destroy relationships. 5. Remain non-judgmental and non-coercive, but encourage people to judge all they are doing by the Choice Theory axiom: Is what I am doing getting me closer to the people I need? If the choice of behaviors is not getting people closer, then the therapist works to help the client find new behaviors that lead to a better connection. 6. Teach clients that legitimate or not, excuses stand directly in the way of their ability to make needed connections. 7. Focus on specifics. Find out as soon as possible who clients are disconnected from and work to help them choose reconnecting behaviors.
  57. 57. COUNSELLING AND GUIDANCE ABINAYA.T., MSW Page 57 If they are completely disconnected, focus on helping them find a new connection. 8. Help them make specific, workable plans to reconnect with the people they need, and then follow through on what was planned by helping them evaluate their progress. Based on their experience, therapists may suggest plans, but should not give the message that there is only one plan. A plan is always open to revision or rejection by the client. 9. Be patient and supportive but keep focusing on the source of the problem: disconnectedness. Clients who have been disconnected for a long time will find it difficult to reconnect. They are often so involved in the harmful behavior that they have lost sight of the fact that they need to reconnect. Help them to understand Choice Theory and explain that whatever their complaint, reconnecting is the best possible solution to their problem. UNIT 5 Expressive therapy Expressive therapy, also known as the expressive therapies, expressive arts therapy or creative arts therapy, is the use of the creative arts as a form of therapy. Unlike traditional art expression, the process of creation is emphasized rather than the final product. Expressive therapy is predicated on the assumption that people can heal through use of imagination and the various forms of creative expression.
  58. 58. COUNSELLING AND GUIDANCE ABINAYA.T., MSW Page 58 Types of expressive therapy Expressive therapy is an umbrella term. Some common types of expressive therapy include:  art therapy  dance therapy, also known as dance/movement therapy  drama therapy  psychodrama  music therapy  writing therapy, a term which may encompass journaling, poetry therapy, and bibliotherapy  Therapeutic Recreation  horticultural therapy Horticultural therapy is often not listed with other expressive therapies; it is not universally considered a form of expressive therapy or creative arts therapy. All expressive therapists share the belief that through creative expression and the tapping of the imagination, a person can examine the body, feelings, emotions and his or her thought process. However, expressive arts therapy is its own therapeutic discipline, an inter-modal discipline where the therapist and client move freely between drawing, dancing, music, drama, and poetry. Although often separated by the form of creative art, some expressive therapists consider themselves intermodal, using expression in general, rather than a specific discipline to treat clients, altering their approach based on the clients' needs, or through using multiple forms of expression with the same client to aid with deeper exploration. Expressive arts therapy is the practice of using imagery, storytelling, dance, music, drama, poetry, movement, horticulture, dreamwork, and visual arts together, in an integrated way, to foster human growth, development, and
  59. 59. COUNSELLING AND GUIDANCE ABINAYA.T., MSW Page 59 healing. It is about reclaiming our innate capacity as human beings for creative expression of our individual and collective human experience in artistic form. Expressive arts therapy is also about experiencing the natural capacity of creative expression and creative community for healing. Music therapy Power of Music by Louis Gallait. A brother and sister resting before an old tomb. The brother is attempting to comfort his sibling by playing the violin, and she has fallen into a deep sleep, "oblivious of all grief, mental and physical." Music therapy is the use of interventions to accomplish individual goals within a therapeutic relationship by a professional who has completed an approved music therapy program. Music therapy is an allied health profession and one of the expressive therapies, consisting of a process in which a music therapist uses music and all of its facets—physical, emotional, mental, social, aesthetic, and spiritual—to help clients improve their health. Music therapists primarily help clients improve their health in several domains, such as cognitive functioning, motor skills, emotional development, social skills, and quality of life, by using music experiences such as free improvisation, singing, and
  60. 60. COUNSELLING AND GUIDANCE ABINAYA.T., MSW Page 60 listening to, discussing, and moving to music to achieve treatment goals. It has a wide qualitative and quantitative research literature base and incorporates clinical therapy, psychotherapy, bio musicology, musical acoustics, music theory, psychoacoustics, embodied music cognition, aesthetics of music, sensory integration, and comparative musicology. Referrals to music therapy services may be made by other health care professionals such as physicians, psychologists, physical therapists, and occupational therapists. Clients can also choose to pursue music therapy services without a referral (i.e., self-referral). Music therapists are found in nearly every area of the helping professions. Some commonly found practices include developmental work (communication, motor skills, etc.) with individuals with special needs, songwriting and listening in reminiscence/orientation work with the elderly, processing and relaxation work, and rhythmic entrainment for physical rehabilitation in stroke victims. Music therapy is also used in some medical hospitals, cancer centers, schools, alcohol and drug recovery programs, psychiatric hospitals, and correctional facilities. History of music therapy Music has been used as a healing force for centuries. Apollo is the ancient Greek god of music and of medicine. Aesculapius was said to cure diseases of the mind by using song and music, and music therapy was used in Egyptian temples. Plato said that music affected the emotions and could influence the character of an individual. Aristotle taught that music affects the soul and described music as a force that purified the emotions. Aulus Cornelius Celsus advocated the sound of cymbals and running water for the treatment of mental disorders. Music therapy was practiced in biblical times, when David played the harp to rid King Saul of a bad spirit. As early as 400 B.C., Hippocrates played music for his mental patients. In the thirteenth century, Arab hospitals contained music-rooms for the benefit of the